BACKGROUND: Few reports have documented the clinical characteristics and treatment outcomes of adult patients with Elizabethkingia meningoseptica infection. METHODS: Medical records of patients over 18 years of age and suspected of having an E. meningoseptica infection from March 1, 2006 to February 28, 2013 were reviewed retrospectively. Their clinical characteristics, antimicrobial susceptibility results, and treatment outcomes were analyzed. RESULTS: E. meningoseptica was isolated from 30 patients. Median age was 68.5 years, and infections were more frequent in males (17, 56.7%). The most common isolation source was sputum (23, 76.7%), and pneumonia was the most common condition (21, 70%) after excluding two cases of colonization. This bacterium was most susceptible to minocycline (27, 90%) and fluoroquinolones, including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%). The mortality rate due directly to E. meningoseptica infection was 20% (6/30), and uncontrolled pneumonia was the only cause of death. After isolating E. meningoseptica, the numbers of patients with pneumonia (9/9, 100% vs. 12/21, 57.1%), history of hemodialysis (5/9, 55.6% vs. 3/21, 14.3%), tracheostomy (8/9, 88.9 vs. 10/21, 47.6%), and median Charlson comorbidity index score (6 [range, 3-9] vs. 4 [range, 0-9]) were significantly higher in non-survivors than those in survivors (p < 0.05, for each). However, only 12 (40%) patients received appropriate antibiotics. CONCLUSIONS: E. meningoseptica infection most commonly presented as pneumonia in adults with severe underlying diseases. Despite the high mortality rate, the rate of appropriate antibiotic use was notably low.
Adult* ; Anti-Bacterial Agents ; Cause of Death ; Chryseobacterium ; Ciprofloxacin ; Colon ; Comorbidity ; Cross Infection ; Fluoroquinolones ; Humans ; Levofloxacin ; Male ; Medical Records ; Minocycline ; Mortality ; Pneumonia ; Renal Dialysis ; Retrospective Studies ; Sputum ; Survivors ; Tertiary Care Centers* ; Tracheostomy

Two young men were seen with nausea, vomiting, dermatitis, seizure after two-four days of occupational exposure to caprolactam, a nylon fiber precursor. There were no significant results in laboratory test, brain CT, EEG except leukocytosis, hyperglycemia. Caprolactam has been shown to induce convulsive disorder in experimental animal studios and Tuma et al (1981) described that one worker acutely exposed to caprolactam developed generalized tonic-clonic seizure with leukocytosis. The coincidence of typical skin lesion with otherwise unexplained generalized tonic-clonic seizure in those young man strongly suggests that caprolactam was causal agent.
Animals ; Brain ; Caprolactam* ; Dermatitis ; Electroencephalography ; Humans ; Hyperglycemia ; Leukocytosis ; Male ; Nausea ; Nylons ; Occupational Exposure ; Seizures* ; Skin ; Vomiting

This is cross-sectional study a potential relationship between air conduction hearing threshold and blood viscosity in normal adult males(n=1677). We measure hearing threshold in frequency level at 500, 1000, 2000, 4000Hz by pure-tone audiometry and RBC profiles contains red cell number, hemoglobin, hematocrit. Blood viscosity replaced by hematocrit that are one major factor of influencing blood viscosity. PTAs(pure-tone averages) measured by hearing threshold averages level at 500Hz, 1000Hz, 2000Hz by pure-tone audiometry. Grades of PTAs(pure-tone averages) are less then 10.0dB group, between 10.0-19.9dB group and excess 20.0dB. The results are significantly association among hematocrit, red cell number and hearing loss(age adjust by ANACOVA).
Adult* ; Audiometry, Pure-Tone ; Blood Viscosity* ; Cell Count ; Cross-Sectional Studies ; Hearing* ; Hematocrit ; Humans ; Male*

Verrucous carcinoma as a well differentiated squamous cell carcinoma appeared in skin and mucosa, so called Ackerman's tumor, is a slow-growing tumor with local infiltration rather than the tendency of metastasis. Though this tumor has been reported by many authors since named by Ackerman, despite the relatively small number of skin cancers, the difficulty in diagnosis due to benignity and pathologic finding and the high recurrence rate has aroused the interest in the disease. In addition, the premalignant region or pathogenesis has not been discovered clearly yet, besides the assosiation with chewing tabacco, but such as the correlation with hereditary carcinogenic factor(gene) in etiology with recent molecular biological approach has been clarified steadly. In the 51-year-old male patient with 1.5 x 1.5cm verrucous carcinoma originating from lower lip, it was possible to achieve a good result in terms of both aethetics and function with the use of surgical excision. Since 1980 when one case originating from postauricular area was reported in 1980, there has been no reports on the case from oral cavity in Korea. Therefore, we report one case of verrucous carcinoma from lower lip, experienced for the first time, on this literature.
Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Diagnosis ; Humans ; Korea ; Lip* ; Male ; Mastication ; Middle Aged ; Mouth ; Mucous Membrane ; Neoplasm Metastasis ; Recurrence ; Skin ; Skin Neoplasms

PURPOSE: In addition to the oncological results, cosmetic results are very important to cancer patients. Currently, the use of oncoplastic surgery is an emerging approach. In this study, we examined the clinical outcomes of the use of a corrective procedure with an absorbable implant, a Vicryl mesh(R), as compared with the use of conventional breast conserving surgery (BCS). METHODS: Fifty six patients who completed questionnaire were enrolled in the study. For 33 cases, BCS was performed concurrently with the use of a Vicryl mesh and for the other 23 cases, conventional BCS alone was performed. Contraindications of the use of corrective procedure were a patient age over 60 year, diabetes, neoadjuvant chemotherapy and a previous excisional biopsy performed on the same breast. Patients rated their cosmetic outcomes by use of a four point scale. RESULTS: For one of 34 cases, the Vicryl mesh was removed due to infection and this patient was excluded from the study. Twenty seven of the remaining 33 patients (82%) who underwent the corrective procedure with Vicryl mesh were satisfied with their outcome. For patients that received conventional BCS only ten of 23 patients (43%) were satisfied with their outcome (p=0.05). Patient age, body mass index (BMI) and tumor location did not affect the cosmetic outcomes of the corrective procedure. When the resection area of the breast was 40-70 cm2, 88% of the patients were satisfied with their outcome. CONCLUSION: This study suggested that the use of Vicryl mesh correction was superior to the use of conventional BCS alone for cosmesis. This method appears to provide a satisfactory outcome for oncoplastic surgery of the breast.
Absorbable Implants ; Biopsy ; Body Mass Index ; Breast ; Cosmetics ; Humans ; Mastectomy, Segmental ; Polyglactin 910 ; Surveys and Questionnaires

BACKGROUND: Few reports have documented the clinical characteristics and treatment outcomes of adult patients with Elizabethkingia meningoseptica infection. METHODS: Medical records of patients over 18 years of age and suspected of having an E. meningoseptica infection from March 1, 2006 to February 28, 2013 were reviewed retrospectively. Their clinical characteristics, antimicrobial susceptibility results, and treatment outcomes were analyzed. RESULTS: E. meningoseptica was isolated from 30 patients. Median age was 68.5 years, and infections were more frequent in males (17, 56.7%). The most common isolation source was sputum (23, 76.7%), and pneumonia was the most common condition (21, 70%) after excluding two cases of colonization. This bacterium was most susceptible to minocycline (27, 90%) and fluoroquinolones, including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%). The mortality rate due directly to E. meningoseptica infection was 20% (6/30), and uncontrolled pneumonia was the only cause of death. After isolating E. meningoseptica, the numbers of patients with pneumonia (9/9, 100% vs. 12/21, 57.1%), history of hemodialysis (5/9, 55.6% vs. 3/21, 14.3%), tracheostomy (8/9, 88.9 vs. 10/21, 47.6%), and median Charlson comorbidity index score (6 [range, 3-9] vs. 4 [range, 0-9]) were significantly higher in non-survivors than those in survivors (p < 0.05, for each). However, only 12 (40%) patients received appropriate antibiotics. CONCLUSIONS: E. meningoseptica infection most commonly presented as pneumonia in adults with severe underlying diseases. Despite the high mortality rate, the rate of appropriate antibiotic use was notably low.
Adult ; Anti-Bacterial Agents ; Cause of Death ; Chryseobacterium ; Ciprofloxacin ; Colon ; Comorbidity ; Cross Infection ; Fluoroquinolones ; Humans ; Levofloxacin ; Male ; Medical Records ; Minocycline ; Mortality ; Pneumonia ; Renal Dialysis ; Retrospective Studies ; Sputum ; Survivors ; Tertiary Care Centers ; Tracheostomy

Dimethylacetamide is widely used in the production of plastics, resins, synthetic fibers, and gums and in purification and crystallization processes. Inhalation of the vapor or skin absorption of the liquid of dimethylacetamide(DMAC) can cause liver damage. Toxic hepatitis possibly attributable to DMAC exposure occurred in seven works among 178 employees who had worked on a new spandex-fiber production line. A large amount of DMAC is used as a spinning solvent for synthetic fibers in the factory. The patients were aged 23-47 years old and composed of five males and two females. They were involved in the process of polymerization(1 patient), spinning(1), take-up(4) and packaging(1). The mean duration of exposure was 10 weeks. They experienced fatigue, dizziness and jaundice. The patients showed elavated total bilirubin, alanine aminotransferase(ALT), and aspartate aminotransferase(AST) levels. The serologic test for viral hepatitis A, B and C were negative, as were the abdominal ultrasonographic scans. Based on the presumptive diagnosis of DMAC-induced toxic hepatitis, they were removed from the workplaces. One or two months after removal from the work, the transaminase levels returned to normal. The patients had no history of significant alcohol use, blood transfusion, recent medication, and drug abuse. As a result, authors could not find any attributable cause of toxic hepatitis but the toxicity by DMAC exposure.
Alanine ; Aspartic Acid ; Bilirubin ; Blood Transfusion ; Crystallization ; Diagnosis ; Dizziness ; Drug-Induced Liver Injury* ; Fatigue ; Female ; Gingiva ; Hepatitis A ; Humans ; Inhalation ; Jaundice ; Liver ; Male ; Plastics ; Resins, Synthetic ; Serologic Tests ; Skin Absorption ; Substance-Related Disorders

OBJECTIVE: To investigate the expression pattern of transforming growth factor-beta-inducible gene-h3 (betaig-h3) within rheumatoid synovial tissue and the regulation of betaig-h3 synthesis in fibroblast-like synoviocyte (FLS). METHODS: Synovial tissues obtained from patients with rheumatoid arthritis and osteoarthritis were obtained during joint replacement surgery. betaig-h3 expression was evaluated with immunohistochemical stain. FLS was isolated from synovial tissues and stimulated with cytokines including TGF-beta, TNF-alpha, IL-1beta, IFN-gamma, IL-6, IL-4, and IL-10. betaig-h3 synthesis was measured using semiquantitative RT-PCR, ELISA, immunofluorescence stain, and flow cytometry. RESULTS: Expression of betaig-h3 was diffuse and abundant in both lining and sublining layers of rheumatoid synovium, which was more prominent than those of osteoarthritis. Production of betaig-h3 in FLS was regulated by TGF-beta1 in a dose-dependent manner and was highest at 5 ng/mL of TGF-beta1. TNF-alpha and IL-1beta upregulated the production of betaig-h3 from FLS synergistically with TGF-beta1 but other cytokines such as IL-4, IL-6, IL-10 did not affect. betaig-h3 synthesis was efficiently inhibited by dexamethasone at higher dose (100 nM) but not by cyclosporine-A. CONCLUSION: Production of betaig-h3, which is highly upregulated in rheumatoid synovitis, is differentially regulated by inflammatory cytokines.
Arthritis, Rheumatoid ; Cytokines ; Dexamethasone ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Fluorescent Antibody Technique ; Humans ; Interleukin-10 ; Interleukin-4 ; Interleukin-6 ; Joints ; Osteoarthritis ; Synovial Membrane ; Synovitis* ; Transforming Growth Factor beta ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha

BACKGROUND/AIMS: Type 2 autoimmune pancreatitis (AIP) has been considered extremely rare in East Asia. This study aimed to clarify the prevalence, clinical characteristics and radiological findings of type 2 AIP highlighting patients presenting as acute pancreatitis in a single center. METHODS: Type 2 AIP patients were classified according to International Consensus Diagnostic Criteria. Radiological findings were compared between type 2 AIP presenting as acute pancreatitis and gallstone pancreatitis. RESULTS: Among 244 patients with AIP, 27 (11.1%) had type 2 AIP (definite, 15 [55.5%] and probable 12 [44.5%]). The median age of patients with type 2 AIP was 29 years (interquartile range, 20 to 39 years). Acute pancreatitis was the most common initial presentation (n=17, 63%) while obstructive jaundice was present in only one patient. Ulcerative colitis (UC) was associated with type 2 AIP in 44.4% (12/27) of patients. Radiological pancreatic imaging such as delayed enhancement of diffusely enlarged pancreas, homogeneous enhancement of focal enlargement/mass, absent/minimal peripancreatic fat infiltration or fluid collection, and multifocal main pancreatic duct narrowings were helpful for differentiating type 2 AIP from gallstone pancreatitis. During follow-up (median, 32.3 months), two patients (2/25, 8%) experienced relapse. CONCLUSIONS: In South Korea, type 2 AIP is not as rare as previously thought. Overall, the clinical profile of type 2 AIP was similar to that of Western countries. Type 2 AIP should be considered in young UC patients with acute pancreatitis of uncertain etiology.
Colitis, Ulcerative ; Consensus ; Far East ; Follow-Up Studies ; Gallstones ; Humans ; Jaundice, Obstructive ; Korea ; Pancreas ; Pancreatic Ducts ; Pancreatitis ; Prevalence ; Recurrence

In the version of this article initially published, the fifth author's name was stated as “Joo Nam Lee.